Objective To explore the effect of comprehensive intervention on constipation caused by antipsychotic drugs.Methods Ninty patients with antipsychotic drug induced constipation who were admitted to our hospital from June 2012 to October 2013 were enrolled in this investigation and randomly assigned to the comprehensive intervention group(CIG,n=46) and the routine care group(RCG,n=44).The subjects of the RCG received routine diet and medication therapy; and those of CIG received comprehensive intervention of life style,psychological ability,cognition,nursing and traditional chinese medicine(TCM) for 3 months.Constipation symptoms scale and Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) were assessed before and after the intervention.Results CIG showed significant improvement in defecation difficulty,defecation force,defecation duration,frequency,abdominal distension,total symptom score,PAC-QOL,physical discomfort,psycho-social discomfort,anxiety and treatment satisfaction were(2.8±2.1),(2.2±1.6),(2.4±1.3),(2.1±1.7),(1.5±0.9),(14.0±8.1)respectively (t values were 2.629,3.818,2.328,2.593,2.578,2.913,7.499,2.570,5.012,2.249 and 12.259,respectively; all P＜0.05).Conclusion Comprehensive intervention may be an effective therapy against psychiatric drug induced constipation.

Objective To evaluate peak left ventricular(LV) apical rotation velocity during early diastole by speckle tracking echocardiography in normal peopleand patients with myocardial hypertrophy because of hypertension. Methods Two dimensional images of left basal and apical ventricular short axis view were recorded in 20 healthy people and 20 patients with hypertension and left ventricular hypertrophy(LVH). Rotation velocity-time curves of six segments in LV apex and base were obtained using Qlab software. The peak rotation velocity in early diastole of LV apex(A-Vel) and base (B-Vel) were acquired through Excel software. Results In LVH group,A-Vel was significantly decreased(P<0. 05) while B-Vel appeared no difference (P = 0.58) compared with healthy individuals. Conclusions Peak LV apical rotation velocity in early diastole can evaluate the change of LV diastolic function in patients with hypertension and LVH.

OBJECTIVETo investigate the value of transesophageal echocardiography to guide the implantation of 2 pieces of MitraClip during transcatheter mitral valve repair operation.

METHODSFrom October 2013 to June 2014, 6 transcatheter mitral valve repair operations were performed in our hospital for symptomatic patients with severe functional mitral regurgitation (MR), transesophageal echocardiography was applied to guide the implantation of 2 pieces of MitraClip. Clinical data are retrospectively analyzed to evaluate implantation timing and approach of the 2nd piece of MitraClip, as well as the immediate effect of the interventional therapy.

RESULTSAfter implantation of 1st piece of MitraClip, transesophageal echocardiography evidenced MR ≥ grade 2 with central regurgitation and immediate mitral average transvalvular pressure gradient < 3 mmHg (1 mmHg = 0.133 kPa) in these 6 patients and 2nd piece of MitraClip was implanted in these patients. After implantation of 2nd piece of MitraClip, it is observed via transesophageal echocardiography that mitral regurgitations were reduced by ≥ 2 grades for all 6 patients. For 3 patients, MR was reduced to grade 1. For the other 3 patients, MR is reduced to grade 2. Among the 3 patients whose MR was reduced to grade 2, 2 operations were stopped because immediate mitral average transvalvular pressure gradient equaled to 3 mmHg, and the rest 1 operation was stopped because MR was too diverse and not able to select proper position to implant the next MitraClip. All 6 operations are completed successfully.There were no myocardial infarction, death or complications requiring mitral valve surgery after the MitraClip procedure. There were also no MitraClip detachment, thrombus embolism, mitral valve apparatus injuries, mitral stenosis, pericardial tamponade post procedure.

CONCLUSIONSTransesophageal echocardiography plays an important role to guide the implantation of 2 pieces of MitraClip in transcatheter mitral valve repair operation. Mitral average transvalvular pressure gradient and initial position of regurgitation after implantation of the previous MitraClip are critical determinants for decision making if the next piece of MitraClip can be implanted or not.

Echocardiography, Transesophageal ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; surgery ; Mitral Valve Stenosis ; surgery ; Prostheses and Implants ; Prosthesis Implantation ; methods ; Retrospective Studies

Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific. Furthermore, the incidence of adverse respiratory events in the PACU was higher in patients with high risk of OSAS than others (6.8% vs. 0.9%, P < 0.001). They also stayed longer than others in the PACU (95 ± 28 min vs. 62 ± 19 min, P < 0.001). Age, high risk for OSAS, and smoking were independent risk factors for the occurrence of adverse respiratory events in the PACU. The BQ may be adopted as a screening tool for anesthesiologists in China to identify patients who are at high risk of OSAS and determine the potential risk of developing postoperative respiratory complications in the PACU.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Anesthesia Recovery Period ; Berlin ; Body Mass Index ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Sleep Apnea, Obstructive ; epidemiology ; Surgical Procedures, Operative ; adverse effects ; Surveys and Questionnaires ; Young Adult